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1 Rancho Cordova, CA Doc: JER Page 1 of FAX MCE to complete shaded area MCE Job Number: Job Name: Date Received: Job Engineer: Logistics Information Job Type Federal Government State Government Other Government Courthouse Hospital School or University Office Building Private Jail / Prison Other Site & Contact Information Site Address Consultant Information Business Name: Contact Name: Business Phone: Owner Representative Print Name: Signature: Cell Phone: Address: Title: Business Phone: Cell Phone: Address: Form Completed By Name: Business Phone: Cell Phone: Contractor Information Business Name: Address: Contact Name: Business Phone: Cell Phone: Address: Shipping Information Ship To Address: Notice Required: 24 hrs 48 hrs Lift Gate Truck Required: Yes No

2 Rancho Cordova, CA Doc: JER Page 2 of FAX Logistics Information (continued) Delivery & Payment Schedule Standard MCE terms of payment (net 30 days) apply to your order. If you require special terms of payment, please provide an Alternative Payment Schedule. Per state tax laws, it is critical that MCE receive exemption or resale certificates prior to the material being shipped and billed. If the job is a tax exempt job, send the exemption certificate with this form. If you are a resale customer and have a resale certificate, please make sure that the MCE accounting department has a copy on file. Customer Job Number: Customer PO Number: Job Name: Number of cars: Control Delivery Date Payment Date Group Delivery & Payment Schedule If different payment terms are required, please provide an alternative proposal. Please include specifics of building owner payments and provide a copy of your contract. Alternative Proposal Provided: Yes No Contract Attached: Yes No Job Push-Outs and Cancellation Jobs pushed out by the customer more than 90 days beyond the originally scheduled date may be subject to cancellation charges as follows: * Before engineering commences: 10% of total sales order * After engineering completed: 30% of total sales order * After construction completed: 75% of total sales order Extra Documentation If this job requires additional engineering drawing packages or additional manuals, please indicate below. Drawing Sets # Required: Manuals # Required: Elevator Safety Code Compliance Accurate information is essential. Both hardware and software are affected. Job Location (City/State): Contract Date: Project Type: New Construction Modernization Elevator Duty: Passenger Service Freight Measurements: U.S./English S.I./Metric U.S. compliance ASME A A A ASME A /98 ASME A17.1- Specify code and addenda. International compliance Australia AS 1735 Britain EN 81/ BS 5655 Canada B44-07 B44-04 B44-00 Other: TSSA Additional state or local code compliance California ( Medical facility OSHPD Seismic Cert. Required) Machine Room sprinklers Chicago Denver Pressurized Hoistway GSA / Federal Heat detectors ( MR Floors ) Hawaii Houston Door Reopen Button, Fire Phase I Maryland Michigan Detroit MR sprinklers New York state New York City White Plains Nassau County MR Sprinklers Pennsylvania Washington ( Seattle) Number of Fire Phase 1 switches: # of 3-position switches: Washington DC Other: Additional Compliance Requirements? Explain: Job Specification # of 2-position switches: Does project have job specifications? Yes No If yes, number of pages: Have specifications been forwarded to MCE? Yes No

3 2 Rancho Cordova, CA Doc: JER Page 3 of FAX Machine room space limitations? Indicate enclosure space available. Otherwise, enclosure size based on job requirements. (Check entry hall and door sizes.) H x W x D Machine room location: Overhead Basement Other Number of machine rooms: Machine room NEMA rating: 1(std) X Air conditioned enclosure (recommended for all but NEMA 1) Type of Operation Simplex Parking Floor: If no parking floor, car stays at last call answered. Selective collective (intermediate floors have two call buttons in hall) SAPB Single Automatic Pushbutton (intermediate floors have one call button in hall) SBC Single Button Collective (intermediate floors have one call button in hall) Duplex Selective Collective (provide hoistway and machine room drawings) Parking: Primary Floor: Secondary Floor: First free car will park at Primary floor. Second free car will park at Secondary floor. If no parking floors, cars stay at last call answered floor. Group Automatic (provide hoistway and machine room drawings) Number of cars: Lobby Landing #: Parking Floors: Number of cars to park: Floors to park at: (If no parking floor, cars stay at last call answered) (Once parking floors are full, other cars stay at last call answered) Swing Car Operation Car(s): Activated by keyswitch: In car In hall Auto swing Cross Registration Existing hall P/B schematics are required. Fire Service Operation Fire Service Phase I Main Landing #: Doors will open: Front Rear Phase 1 Switch is: 2-position 3-position Alternate Landing #: Doors will open: Front Rear Additional 2-position switch: Yes No Switch location: Landing #: Master Fire Service switch (Chicago High Rise only) Fire Service Phase II Type of switch: 3-position 2-position Call Cancel Button: Yes No Shunt Trip Delay If required/permitted by jurisdiction [Nassau County NY, Detroit MI, California, Federal], delays sprinkler until after elevator lands at next available floor. Heat Detector Locations: Machine Room Each floor Operating Features Attendant Service Yes No Attendant Annunciator Panel in car (Visual hall calls) Car-to-Lobby switch Yes No Location: Car Hall Remote Panel Park with doors: Open Closed Return Landing#: Earthquake Service Yes No ASME A17.1 code California code Traction machine Winding drum machine Seismic switch By MCE By customer Counterweight derailment device By MCE By customer Car to operate on fire or hospital service Emergency Medical Technician Service (EMT) Yes No Return landing #: Floor label: Emergency Power Generator Yes No Does generator power other cars? Yes No If yes: Sequential lowering? (requires emergency power overlay) If not sequential: Number of cars to run at a time: : Emer pwr contacts during normal pwr: Open Closed Power pre-transfer contact 10 sec minimum Manual Select Switch Number of positions: Labels: Is emergency/standby power selector switch located at the designated level in view of all elevator entrances? Yes No Flood Operation Yes No Lowest landing that the car can go in an event of a flood: Landing: Hoistway Access Operation Yes No 2-position switch in COP: Yes No Top access switch: Yes No Switch location: Front Rear Bottom access switch: Yes No Switch location: Front Rear Hospital Service (Code Blue) Yes No Mark number of each car used for hospital service: Landing numbers served: Number of hospital risers: If more than one, list cars assigned to each: #1: #2: #3: #4: Hospital Phase 2 Activation: Hospital Phase 2 switch Hospital service indicators Standard operation: Phase 1 light flashes; Phase 2 lights continuous In-Car Inspection switch Yes No Using top/bottom car calls or up/down buttons Independent Service Yes No Key switch location: Car (standard) Hall Pre-test switch in Controller Select In-Car Access & Inspection Switch Style Only for ASME A /CSA B44-00 or later 2-Position (indicate) 3-Position NORMAL ACCESS INSPECTION NORMAL OR ACCESS NORMAL INSPECTION Requires Access Requires Inspection Requires Access & Inspct

4 Rancho Cordova, CA Doc: JER Page 4 of FAX Operating Features (continued) Sabbath operation Yes No Security Yes No Car call cutouts: Yes No Card reader dry contact Keyed floor lockout switches Switch location: Car Hall Number of switches: Car Call Card Reader Override Switch Hall Call Cutouts: Yes No Card reader dry contact Keyed floor lockout switches Car call code security: (enter security code using car call buttons) Security control via: PC Key on/off switch Bypass Security: (Fire service bypass is standard) Independent Service Attendant Service Other Specify: Special Security Features: Jail Security * Deputy/Marshal Service* Remote Car Station Control Evacuation Service * Child / Infant Abduction / Bracelet Operation Number of landings with detection device: Which Landings: Landing #: Floor label: Allow car to run if not at affected landing: Yes No Other * ( ) * additional details must be provided Timed Fan Light Output: Yes No Used to turn cab fan/lights off after idle for user adjustable length of time (To 10 minutes); fan/lights to turn on if car in demand. Load Weighing Yes No EMCO Load Weigher EMCO Rope Tension Load Weigher, Car: Number of ropes: Roping: 1:1 2:1 Rope diameter: 10mm 1/2 in 9/16in 5/8 in If additional cars use same roping, and more load weighers are needed, indicate quantity here: If car roping varies, provide information for each car below. EMCO Rope Tension Load Weigher, Car: Number of ropes: Roping: 1:1 2:1 Rope diameter: 10mm 1/2 in 9/16in 5/8 in EMCO Rope Tension Load Weigher, Car: Number of ropes: Roping: 1:1 2:1 Rope diameter: 10mm 1/2 in 9/16in 5/8 in K-Tech strain gauge (from MCE) K-Tech strain gauge (from other) Model: Other weigher Brand: Model: Discrete weigher (dry contact interface) Anti-nuisance Lobby dispatch Hall call bypass Overload Hoist Monitoring Yes No mview complete in machine room mview interface only to allow future connection imonitor / ireport, machine room or remote imonitor / ireport interface only allow for future connection IDS Liftnet Interface Number of monitoring stations: Distance from group to monitoring station: ft Is distance greater than 300ft? Yes No

5 Rancho Cordova, CA Doc: JER Page 5 of FAX General Information Voltage Line voltage available (disconnect): Line voltage measured: AC 3 phase (symmetrical with respect to ground) AC 3 phase (grounded leg delta configuration)* AC 2 phase AC single phase DC 60 Hz 50 Hz * Isolation Transformer required Add Isolation Transformer: Yes No Add Voltage Surge Suppressor: Yes No Add Brown Out Circuit: Yes No Add Traction Auxiliary Power Supply(Backup power for controller, only up to 40hp) Yes No Machine blower Voltage: Phase: FLA: Reduced stroke buffers Buffer rating: fpm Counterweight safety Jawless Governor (tension sheave switch required) Regenerative Drive: Yes No (returns overhauling power to main line) Machine and Brake Machine Existing New (complete additional form) New (by MCE complete additional form) MRL (machine roomless) Brand: Geared Ring & Worm Helical External Tandem Gearless AC PM AC Induction Encoder model: Roping: 1:1 2:1 FOR MRL APPLICATIONS ONLY: Battery Backup Passenger Rescue w/video Remote Governor Set/Reset Coil Voltage: Brake Existing New Brand: DC Brake (* Required Information) Voltage: *Pick: *Hold: *Coil resistance: Measured Data Sheet Contact on brake Type: N/O N/C AC Brake (* Required Information) *Current/Fuse Size: Voltage: Phase: Single 3-phase Emergency Brake ASME A /CSA B44-00 or later requires the addition of an emergency brake on all new traction elevators, per Also note that some alterations will trigger the requirement to add an emergency brake as well (i.e., change in type of service or motion control; increase in rated load or speed; and replacing the driving machine) Hollister Whitney Rope Gripper Thyssen Sheave Brake Bode Rope Brake Other ( ) Secondary/Independent Brake on machine (not accepted in Nebraska) Power Supply of Brake: 120VAC, 3A slow-blow fuse (Std) Other If other, please specify: Voltage: FLA: Hoist Motor Variable Frequency AC Existing New New by MCE (fill additional form) Brand: HP: Volts: FLA: FL RPM: # Poles: Sync RPM: Frequency: For 2-speed motor, measure high speed winding. Encoder cable length: Other name plate data: Variable Voltage DC Existing New New by MCE Brand: Volts: HP: RPM: FLA: Other name plate data: Shunt field voltage: Forcing: Full Speed: Standing: Shunt field resistance: Measured Data Sheet # of coils: Series Series/Parallel Hot Cold Loop Circuit Voltage while running (measure on motor brushes): Up empty car: VDC at speed: Down empty car: VDC at speed: Loop Circuit Current while running: Up empty car: Amps at speed: Down empty car: Amps at speed: Velocity feedback By MCE By other Tachometer Flange Foot Encoder Encoder cable length: If gearless: Drive sheave diameter: Diameter of surface to run tach:

6 Rancho Cordova, CA Doc: JER Page 6 of FAX Car Gate Door Operation Automatic passenger style doors Powered freight style doors Manual doors Other: Gate Release Solenoid (not standard) Voltage: 3-Phase AC 1-Phase Fuse: 2A 3A Other: Hoistway Doors Automatic passenger style doors Powered freight style doors Manual doors (complete below) Other: (complete below) Interlocks: Door Closed contact Yes No Door Locked contact Yes No Brand: Model: Door locking cam Retiring (not driven by automatic passenger style car gate) Voltage: 3-Ph AC 1-Ph Fuse: 2A 3A Other: Fixed cam Bar lock (manually operated) Mechanical (driven by automatic passenger style car gate) Door Features Infrared detector unit/photo eye Cut-out switch in COP Anti-Nuisance Mechanical safety edge Heavy doors at landings (list landings): Dual door operators on same side for wide opening Cartop door open/close buttons (non solid state door operators) Door Hold Operation (non-fire operation) Switch Button (max hold = 120 seconds) Nudging Reduced torque with buzzer Buzzer only Ignore photo eye after x interval If safety edge or door open button activated, doors should: Stop Re-open Other: Sketch or Special Instructions Automatic Passenger Style Doors (See section below for freight style doors) MCE SmarTraq Complete (Complete SmarTraq data forms) SmarTraq Upgrade (Upgrades existing operator to closed loop. Mark existing model below.) GAL MOVFR I MOM/MOH MOVFR II MOMVC/MOHVC MOD (230V) MOSVCL MOD (115V) MODHA MOPM-P/MOPM-PL MOCT/MOCTA/MODCT/ MOMCT/MOHCT MODVC/MODHVC Motor Voltage: MOA Logic Voltage: MAC/Kone PM-SSC/104 Board AMD/Kone TKE/Dover HD03 MAC (old style) HD68/70/73/91 (Circle model number) HD98/85 (Requires SmarTraq upgrade kit) Smart tech Otis 6970A Resistance 6970A Reactance 7300 A7770A 7782AA OVL imotion 1 & 2 AT400 ECI 895/ Other IPC Encore (closed loop) Mitsubishi LV1/4K Delco (closed loop) Schindler QKS 14 & 15 Atlantic/Vertisys Model: Other (wiring diagram required): Powered Freight Style Doors Door Controller Model Peelle New Model: Existing (electrical schematic required) Courion New Model: Existing (electrical schematic required) EMS New Existing (electrical schematic required) Other New Existing Model: (electrical schematic required) Door Operation (freight only) Opening: Automatic Momentary pressure Closing: Automatic Momentary pressure Constant pressure Fire Phase l Closing: Automatic Momentary pressure Constant pressure

7 Rancho Cordova, CA Doc: JER Page 7 of FAX Call Registration Indicators All push buttons designed as standard mechanical style unless noted on special instructions. Car Calls Type: LED Neon Incandescent Hall Calls Type: LED Neon Incandescent Auxiliary Car Station: Yes No Total # of car stations in each car: Serial Link (Fixtures must be 24VDC, 6 watts max) Car Operating Panel Hall Calls # of risers: Call pushbuttons must be mechanical. Position Indicators Car *Customer supplied serial driver board* (not in controller) *Discrete signals* (Multi-Light or non-serial digital) *Provide information below: AC +DC -DC Type: Multi-light Digital (not MCE Driver board) Model: One line per floor Binary code begins at landing Brand: Hall Location: All floors Main fire return 0ther: *Customer supplied serial driver board* (not in controller) *Discrete signals* (Multi-Light or non-serial digital) *Provide information below: AC +DC -DC Type: Multi-light Digital (not MCE Driver board) Brand: Model: One line per floor Binary code begins at landing Voice annunciation MCE CE 3-wire driver board interface (built into controller) MCE E-Motive 3-wire driver board interface (built into controller) By other, discrete signals requested (i.e., fire service): Custom messages-non standard please indicate below Special Instructions Lanterns: Car lanterns Discrete signals Bulb wattage Type: Chime Gong Hall Lanterns Discrete signals Bulb wattage Type: Chime Gong Passing floor signal Discrete signals Type: Chime Gong Passing floor enable ( s button) Status Indicators Type Volts Attendant Light Attendant Buzzer EQ Indicator/buzzer Annunciator panel display Call Registration Buzzer Door Closing Buzzer (typically freight only) Door Hold Light Door Left Open Bell Emergency Power Light EMT Service Light, Car EMT Service Light, Hall Fire Light Fire Buzzer Hospital Light Hospital Buzzer In-Service Light In-Use Light Load Status Light Nudging Buzzer

8 Rancho Cordova, CA Doc: JER Page 8 of FAX Landings & Openings Ldg # Floor Label O.H. PIT Capacity: kg lbs Up Speed: ms fpm Down Speed: Total Travel: m ft Floor Car Car Car Car Car Car Height F R F R F R F R F R F R Number of hoistways: Hoistway NEMA Rating: 1 (standard) X Other: Sprinkler Installations In machine room In hoistway In pit at 24 or less (NEMA 4 required below 48 ) EECO limit switches by MCE for Final limits only TM Switch (music box) Hand held Unit mpac (Recommended but not required) MCE Traveling cable If yes, please fill out cable data form NOTE: Floor Label note: If using CE or E-Motive driver board, floor label should not be more characters than the number of digital PI display characters ( )

9 Rancho Cordova, CA Doc: JER Page 9 of FAX NOTE: Hoistway Layout Forms are required for each unique landing configuration including riser, opening, and wall/barrier location. These forms must be filled out by hand and faxed to MCE. Enter the number of drawings you are submitting here:

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